Health & Wellness

CBD and Insomnia: What You Need to Know

By Mary Sauer
Kinga Cichewicz/Unsplash

Can CBD oil help with insomnia? First, let’s talk about what insomnia is and how it’s currently treated.

Difficulty falling asleep and staying asleep is a problem the plagues a surprising number of adults. One in four Americans will develop acute insomnia each year, according to Penn Medicine News. Acute insomnia is characterized by difficulty sleeping that lasts between two weeks and three months. Chronic insomnia, lasting more than three months, is a prevalent health concern as well, plaguing an estimated 10 percent of the adult population in the United States.

The effects of insomnia are far reaching. Individuals suffering from a sleep disorder already know about the exhaustion, brain fog, and mood changes that can follow a poor nights sleep. Beyond the short term effects, chronic insomnia is also linked to obesity, diabetes, mental health disorders like anxiety and depression, and high blood pressure, according to Sleep Disorders and Sleep Deprivation.

This means that, for individuals dealing with disruptions to their sleep, concerns extend beyond their everyday performance out to their overall wellbeing and the future of their health.

How is insomnia treated?

Ask anyone with a sleep disorder, insomnia can be hard to treat. There are some who simply need to change a few habits or add a supplement to their bedtime routine before they can get some consistent rest, but others go through a lot of trial and error before figuring out what works for them.

Common treatments for insomnia include lifestyle changes, like getting more exercise, reducing caffeine, and reducing stress. Others may be asked to practice good sleep hygiene, forming habits like staying away from screens before bed, avoiding eating too late, and making adjustments to their sleep environment to make sure they are comfortable.

Supplements and medication can come into play as well. Some individuals turn to melatonin, a hormone that naturally occurs in the body that can be taken as a sleep aid. While melatonin is generally considered to be safe for the long term, it’s effectiveness is hit and miss for individuals with insomnia and there is no clear research on potential long term effects on the body’s ability to produce this hormone if it is being administered long term through a supplement.

Beyond that, individuals may be prescribed a sleep aid by their doctor. Ambien is by far the most common option, according to Rachna Patel, MD, who specializes in the treatment of chronic disease using CBD and medical marijuana, but it also comes with some potentially severe side effects, including sleepwalking and hallucinations.

“It is only meant to be used short term but often what ends up happening is that it does get used long-term,” she says. “Worst case scenario, we have a patient in the middle of the night get into their car and drive off.”

CBD as a Treatment For Insomnia

More individuals with mild to moderate insomnia are turning to cannabis-derived products to get a better night’s sleep. Research on cannabis-derived products is still young, and Patel admits they don’t have all the pieces of the puzzle, but there are few pieces of evidence as to why cannabidiol oil is such a good fit for managing sleep disorders.

“The endocannabinoid system is involved in the regulation of sleep, specifically your circadian rhythm, what’s otherwise known as the sleep-wake cycle,” explains Patel, referring to studies that have found that cannabinoids are present in higher levels in the body upon waking and that sleep deprivation actually disrupts the endocannabinoid system, as we see in a 2010 study published in the British Journal of Pharmacology.

While finding the right dosage can be tricky, CBD oil is generally a really good fit for those looking for fewer side effects and a sleep aid that won’t make them groggy.

“One mechanism by which CBD works may be through a general calming of the nervous system,” explains Alex Dimitriu, MD, double board-certified in Psychiatry and Sleep Medicine and founder of Menlo Park Psychiatry & Sleep Medicine. “Cannabis strains will differ in the ratio of CBD to THC, and additional substances, called terpenes, may also play a role in determining whether the effect is activating or sedating. Generally speaking, Indica strains tend to be more sedating.”

For individuals concerned about the psychoactive properties of products containing THC or those who live in states that have not legalized medical or recreational marijuana, it is good news to know that it is cannabidiol that appears to positively affect sleep, according to Patel. This means individuals with insomnia can stick with a cannabidiol oil containing less than .3% THC.

“What I have seen is that patients are able to fall asleep more easily, the stay asleep…and they wake up feeling refreshed,” says Patel. “A lot of other over-the-counter and prescription medication leave patients feeling groggy and that is not the case with CBD.”

Potential side effects are few, including drowsiness or diarrhea with dosing that is too high. Some individuals might notice a change in their appetite or weight, but this is also associated with taking too much, according to Patel.

Finding the Right Dosage of CBD

Finding the right dosage of CBD for insomnia can be challenging, according to both Dimitriu and Patel.

When it comes to deciding on a product and the dosage, there are variables to consider and finding the right dose might be fairly involved. One reason for this is that the strength of CBD oil varies in products. Additionally, individuals seem to have a varying response to CBD, including a need for different strengths and dosages. Lastly, patients will need to determine the appropriate frequency for taking CBD oil based on their specific needs.

While patients may attempt to “DIY” dose their cannabidiol oil as a sleep aid, too much may leave them feeling drowsy and too little could actually create further disruptions to sleep, according to Patel.  The recommendation from both doctors is to find a provider who is experienced with the use of CBD oil as a sleep aid. If that is not possible, the best alternative is involve your provider anyway in making an educated decision.

“If providers are not aware of the research around CBD, I advise patients as well as providers to look at PubMed—an online repository of research, which will often point to the health benefits and established doses and research around substances like CBD,” suggests Dimitriu.

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